Nursing as a career

By Taru Bahl

TALK of nursing and the mind conjures up the ethereal image of Florence Nightingale making the rounds of the makeshift hospital ward with her trademark lantern, gently attending to wounded soldiers of the Crimean War. Even today she is a role model for aspiring and serving nurses the world over. In the USA there is this successful Florence Project — where thousands of nurses have united in their mission of returning health to health care.

Nursing is not just an attendant's job. Functional responsibility includes much more than making the patient feel comfortable and administering medication under surgical surveillance. Today, you have specialisations within the field of nursing and can choose from areas like critical care, home health, flight nursing, cardiac, forensic and geriatrics. Informatics, legal management, medical-surgical, midwife, telenursing, travel nursing, rehabilitation, renal/dialysis, injury management, drug and alcohol testing are among other focused niche segments of medicine. Besides exuding a no-nonsense air of professionalism, a nurse is supposed to be the compassionate comfort-giver, to the patient and the family. Her role embodies the best of the medical profession and the finest humane qualities.

Wherever you may choose to do your nursing degree from, you will have the choice of seeking career openings in the hard core medical side — in hospitals, nursing homes, dispensaries, poly clinics, the Armed Forces, sanatoriums, rehabilitation centres and medical establishments. On the softer side are career options in industrial plants, factories, beach resorts, hotels, crèches, educational institutions, old age homes and fitness centres where medical facilities are made available to end users. You could be working in urban, rural or far-flung areas, depending on your personal preference and professional background.

Nursing can broadly be classified under five categories: General, psychiatric, school, midwife and industrial. Usually the career graph of a nurse moves from the level of a ward sister to that of a tutor, senior nursing superintendent up to that of the matron. A general duty nurse is whom we usually encounter on our routine visits to hospitals. They work on an eight to 10-hour-long shift and provide back-up support to the doctors and surgeons. They record temperatures, administer medicines, maintain updated records, change dressings, prepare patients for surgery, translate medical advise, undertake administrative and financial tasks and are available on call.

School nurse as the name suggests, supervise student clinics, visit schools and colleges handle routine things like eye check-ups, recording of body-weight ratios and dental checks. Talks on nutritional aspects, blood donation, AIDs awareness, organising of Hepatitis camps are held under their supervision. School nurses have to be familiar with child psychology. You could specialise in child and adolescent psychiatric care. School nurses are often sent to educational institutions to teach first-aid and give lectures on health and hygiene.

As a psychiatric nurse you would be working with physically and mentally handicapped people as well with those who are emotionally disturbed. You will have to synergise your efforts with those of the doctor, physician, psychiatrist, occupational therapist and counsellor. You would also be the critical link between the family and the patient.

Often the family reaches out more to the nurse rather than the doctor or surgeon. This is again more to do with perception. The common belief is that while the doctor may be too busy or technical in his diagnosis, the nurse would be gentle and compassionate. She would have more time to explain and reassure. Which is why whenever one comes across a nurse who is abrupt or uncooperative, it is a rude shock because no one expects her to be like this.

Industrial nurses, work under the watchful eye of industrial physician and are responsible for providing preventive, remedial and educational nursing services. They are geared to handle emergencies and have functional knowledge of the industry or factory work ethos. Depending on the industry they are attached to, they provide consultation and advise to workers and their families. Mines, plantations, excavation sites, processing units, match box and carpet industries need doctors and nurses who understand the long term ramifications of their work climate and can offer preventive medical care to minimise risk to life, health and overall well-being.

Midwife nurses are attached to maternity and gynaecological sections of a hospital or a private clinic. Their core competencies should lie in neo and postnatal care as also paediatric nursing. They could be attached to the Ministry of health at the state and Central Government level or with NGOs who are working at the grassroot level in the field of maternal and child care. Setting up awareness camps, check-up and innoculation centres, undertaking door-to-door surveys, distribution of literature and family planning measures can be handled by a team of competent nurses. As a trained midwife you should be able to take complete charge of delivering babies and counselling the mother during the pre and postnatal stages.

To become a nurse you have to do your B.Sc or M.Sc in nursing, preferably from institutes which are recognised by the Director General Health Services. If you wish to cut down on your study period you could go in for diplomas in auxiliary nursing, midwifery, health working etc which are for a period ranging between 12-18 months and can be opted for after class X. As you work along you can pick up short duration courses which prepare you for advanced duties in the operation theatre, cardiac care and oncology sections.

States like Kerala, Andhra and MP offer courses only to candidates who are domiciled there. Some of the places offering admission on an all-India basis are AIIMS, Smt Sucheta Kriplani Hospital, Sri Ganga Ram Hospital, Safdarjung, Holy Family, Ram Manohar Lohia and Raj Kumari Amrit Kaur Hospitals in Delhi, SNDT in Mumbai, AFMC in Pune, Colleges of Nursing in Jaipur and Ludhiana.

A postgraduation degree in nursing would enable you to pick up a teaching job in any of the training or nursing institutions. If you are serious about career progression you must upgrade your skills. Since the medical profession is vast and varied you can identify areas while you are on the job. Adding value to your professional calibre will give you greater job satisfaction besides the increased remuneration.

It will give you a more holistic understanding of the area you have chosen to work in.

Private nurses or freelance nurses too are in great demand since the concept of home health care is beginning to pick up in India. Supplemental staffing and nursing pools are created where quality personnel is supplied to hospitals, nursing homes and individuals with the intent of complementing full time staff. Nursing is no cakewalk. Idealism has to be peppered with realism for you should be physically and mentally prepared for the gruelling work schedules ahead of you.

Even if you are in a time-bound assignment there would be occasions when you may have to do a double-shift. Temperamentally you have to be unflappable — concerned and caring but at the same time clinical and officious. You would be facing health risks yourself since you are all the time exposed to disease, infection, ionised radiation and other anaesthetic substances. Patients could be cranky, demanding and irritable. You may have to go beyond your call of duty and perform tasks which do not fall under your brief. Nursing is considered one of the noblest professions and you must take it up only if you are committed enough.